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Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery

Akhtar, MM; Bhan, A; Lim, ZY; Akhtar, MA; Sekhri, N; Bharadwaj, P; Mullen, M; (2018) Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery. Open Access Journal of Contraception , 9 pp. 57-61. 10.2147/OAJC.S165827. Green open access

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Abstract

The Nexplanon® implant is a commonly used radiopaque contraceptive device that contains progestogen associated with an ethylene vinyl-acetate copolymer resulting in a slow release of the active hormonal ingredient. It is inserted into the subdermal connective tissue and provides contraceptive efficacy for up to 3 years. Device removal for clinical, personal or device “end-of-life span” reasons is straightforward. In rare cases, implant migration can occur locally within centimeters of the insertion site. Distant device embolization is extremely rare and can result in complications including chest pain, dyspnoea, pneumothorax and thrombosis or prevent conception until the active ingredient is depleted. We present one such case, where a Nexplanon® implant embolized into the pulmonary artery of a young female patient. We describe the initial “missed” diagnosis of embolized device on a chest radiograph and subsequent successful percutaneous removal once distant embolization was diagnosed.

Type: Article
Title: Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery
Open access status: An open access version is available from UCL Discovery
DOI: 10.2147/OAJC.S165827
Publisher version: https://doi.org/10.2147/OAJC.S165827
Language: English
Additional information: This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
Keywords: Nexplanon®, pulmonary artery, embolization, extraction, snare
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
URI: https://discovery.ucl.ac.uk/id/eprint/10054064
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